Doctors at Severance Hospital have found that surgical treatment can increase the survival rate of patients with advanced non-small cell lung cancer (NSCLC) who are receiving targeted chemotherapy.
Most stage 4 lung cancer patients see their cancer cells spread to other organs. This is why hospitals generally prefer chemotherapy to surgery.
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“The same goes for lung cancer,” the hospital said. “With the introduction of the concept of oligometastasis, which means there is a small number of cancer cells that have spread to other organs even at stage 4, hospitals have also started surgery and radiotherapy.”
In the case of NSCLC, the survival rate increases with the development of targeted anticancer drugs because they target certain genes or proteins, such as epidermal growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and fusion of receptor tyrosine kinase 1 (ROS1), which promote development. and influence cancer survival.
However, drug resistance develops, even with targeted anticancer drugs, making it difficult to continuously administer the same drug to patients.
To find the best solution to address the two problems, the team, led by Professors Hong Min-hee of the Department of Oncology and Park Seong-yong and Park Byoung-jo of the Department of Thoracic Surgery, evaluated the safety, efficacy and the utility of surgery in 44 advanced NSCLC patients who underwent primary cancer surgery from 2018 to 2020 during targeted chemotherapy at Yonsei Cancer Hospital.
All 44 patients had stage 3 or higher NSCLC, while 32 patients had EGFR mutations, 11 ALK mutations, and 1 ROS1 mutation. The hospital performed lung resection and lymph node dissection for the patients.
As a result, there was no surgery-related death and no cancerous tissue was found in the pathological tissue of four patients. After a two-year follow-up, progression-free survival (PFS) and overall survival (OS) were 70.8 and 95.0 percent, respectively.
“This is a much better result than previous studies,” the team said. “In general, when only targeted anticancer drugs are used, the two-year PFS rate is 10-30 percent and the OS rate is 50-80 percent.”
The team also found that they could enhance the treatment effect through next-generation sequencing (NGS) on pathological tissue after surgery in some patients. When the team discovered a genetic mutation through genetic testing that was resistant to the existing anticancer drug, they were able to create a new treatment plan by modifying the anticancer drug.
‘Through surgery, the hospital can obtain information on the patient’s treatment and suggest a more effective therapeutic direction,’ said Professor Hong. “Based on the results of this study, we are preparing for a prospective study.”
The research result was published in the latest issue of Cancer.
[ https://trends.filmyone.com/even-late-stage-lung-cancer-patients-can-live-longer-with-surgery-2/ https://d26toa8f6ahusa.cloudfront.net/wp-content/uploads/2021/07/30214746/a-quiet-place-part-2-bigs-16.pdf